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Botswana’s Obesity Crisis

If you’d like to take a look at the biggest health crisis facing our nation at this time, look no further than your waistline.


My wife and I are avid walkers. We noticed, in the months leading up to the Gaborone Marathon, a significant increase in activity on the road. Not more cars, but more runners. It’s so admirable to see committed people gathering the energy and the discipline to follow a new lifestyle programme. As a cardiologist living in a country where heart disease kills more Batswana than all other diseases put together, I felt the excitement. At last, a fitness revolution! Or so I thought. Now that the marathon has come and gone, my wife and I still go out for our evening strolls, as is our custom, but we only get to see a fraction of the joggers. The rest have disappeared.

Obesity the killer

Mpho Senzeni* is 60 and has been living with

diabetes for almost 30 years. Like many with the disease, she is also suffering from high blood pressure. A year ago, she started having pains in her chest and a heart attack soon followed. She underwent urgent open-heart surgery and, quite miraculously, she pulled through. It sounds terrible and it is. But Mpho’s problem is not that she is getting older, or that she has diabetes or that her blood pressure is too high. No. Her real problem is her weight. It’s going to take much more than medication to lower her health risks. It’s going to take a total lifestyle overhaul. Mpho has plenty of company. Millions of people around the world share the exact same physical profile. The World Health Organisation (WHO) estimates that there are more than 1 billion obese people in the world. The projection isn’t pretty either, by 2015, WHO estimates worldwide growth of the obesity epidemic to top 1.5 billion. Staggering.

The world is getting fat. The unfortunate truth is that many of the victims are simply unaware of the true risks they are incurring – especially in low to middle income countries, like Botswana. The rapid increase in obesity in Botswana predicts an overwhelming chronic disease burden for our country in the next ten years. We need to take action now. If I told you that according to research, not even one country in the world has been able to reduce its obesity statistics, would you believe me? You should, because it’s true:

losing weight on a national level is a complicated problem and nobody has solved it yet. My experience tells me that if you’re overweight, you are immediately at much higher risk to develop heart disease, strokes and diabetes. These are conditions which kill nearly 2000 people per hour, worldwide. Now, of even greater concern to us as society is what’s happening to our children. Unlike adults,

Beat the Belly Bulge Forget the latest food and fitness fads – staying shape is
Beat the Belly Bulge
Forget the latest food and fitness fads – staying shape is
1. Make smarter food choices
Cut back on fizzy drinks and fried food, which are extremely high
in fat and sugar. Get more serious about fruit and vegetables.
2. Watch your portion size
Reduce your portion size and watch the weight slip away.
3. Realise that you do have time
30 minutes is by no means too much time to spend exercising. This is
only 2 percent of your day.
4. Reduce your screen time
You’ll find a million distraction on your TV, computer or iPad. The more
time you spend in front of these screens, the fatter you get.
5. No more stop-start routines
All you need is a tiny amount of discipline and consistency and great
things will happen. Your body wants to lose this weight.


children cannot choose the environment in which they eat. They have a limited understanding of the consequences of they behaviour. Basically, it’s a parent’s job to control the family’s calorie intake, and a great deal of parents in Botswana are failing their children in this department. Of course, urbanisation takes its toll too. As more families move into towns and cities, so their healthy diets disintegrate. Living in an urban area dramatically increases your exposure to salt, sugar and fat – yielding further escalations in both adult and child obesity. Worldwide estimates show that over 22 million children under the age of five are already obese. What chance do they have? If this trend continues, many of my international peers in this field have suggested that our generation of children may be the first to die at a younger age than their parents.

Mission impossible?

If Botswana wants to become the first country in the world to solve the obesity problem once and for all, I believe everyone has a role to

problem once and for all, I believe everyone has a role to The average Motswana knows

The average Motswana knows a lot about Malaria, HIV-AIDS and others, but very little about the benefits of diet and exercise.

play: government officials, businesses leaders, school teachers, health care workers and most importantly, you and I – as individuals. Is this mission impossible? In my opinion, government has done a great job with public education campaigns for many diseases. And it shows on the ground. The average Motswana knows a lot about Malaria, HIV-AIDS and others, but very little about the benefits of diet and exercise. To me, this signifies a gap or blockage in the flow of information to people who need it. We need to make this information available. Secondly: incentives. One would think that healthy living would be its own reward, but that’s not the case. Healthy choices need to be incentivised. In the United Kingdom, for example,

health care workers receive a pay bonus if they successfully encourage a patient to quit smoking. (So successful has this idea been that over 250 000 people registered to take part in the UK’s first ever stop smoking event in October last year.) Combined with effective public education interventions, it’s an incentive system that works. Maybe it’s time we did something similar – before it’s too late.

*Name has been changed.

Prof KIRAN BHAGAT is a cardiologist and founder of Heart Foundation Botswana (HFB). His mission is to empower communities and reduce the overwhelming prevalence of heart disease in this country. Want to learn more? Call +267 371 0300